The Last Lecture

The Last Lecture
“Let’s be clear. My goal is to be alive and on your brochure in ten years.”
I turned out to be among the minority of patients who could
benefit from what is called the “Whipple operation,” named for a doctor
who in the 1930s conjured up this complicated procedure. Through the
1970s, the surgery itself was killing up to 25 percent of patients who
underwent it. By the year 2000, the risk of dying from it was under 5
percent if done by experienced specialists. Still, I knew I was in for a
brutal time, especially since the surgery needed to be followed by an
extremely toxic regimen of chemotherapy and radiation.
As part of the surgery, Dr. Zeh removed not only the tumor, but my
gallbladder, a third of my pancreas, a third of my stomach, and several
feet of my small intestine. Once I recovered from that, I spent two
months at MD Anderson Cancer Center in Houston, receiving those
powerful dosages of chemo, plus daily high-dose radiation of my
abdomen. I went from 182 to 138 pounds and, by the end, could hardly
walk. In January, I went home to Pittsburgh and my CT scans showed no
cancer. I slowly regained my strength.
In August, it was time for my quarterly check-in back at MD
Anderson. Jai and I flew to Houston for the appointment, leaving the
kids with a babysitter back home. We treated the trip like something
of a romantic getaway. We even went to a giant water park the day
before—I know, my idea of a romantic getaway—and I rode the speed
slide, grinning all the way down.
Then, on August 15, 2007, a Wednesday, Jai and I arrived at MD
Anderson to go over the results of my latest CT scans with my oncologist,
Robert Wolff. We were ushered into an examining room, where a nurse
asked a few routine questions. “Any changes in your weight, Randy? Are
you still taking the same medications?” Jai took note of the nurse’s
happy, singsong voice as she left, how she cheerily said, “OK, the doctor
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